National Core Indicators - Aging and Disabilities


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The National Core Indicators-Aging and Disabilities (NCI-AD™) is an initiative designed to support states’ interest in assessing the performance of their programs and delivery systems in order to improve services for older adults and individuals with physical disabilities.  NCI-AD is a collaborative effort between the National Association of States United for Aging and Disabilities (NASUAD) and the Human Services Research Institute (HSRI).  NCI-AD’s primary aim is to collect and maintain valid and reliable data that give states a broad view of how publicly-funded services impact the quality of life and outcomes of service recipients.

NCI-AD brings an important value proposition to the field of aging and disability services through development of indicators and outcomes that assess quality of life, community integration, and person-centered services. The project will help to address long-recognized gaps in assessing outcomes in long term services and supports (LTSS) service systems that go beyond measures of health and safety to address important social, community, and person-centered goals as well as quality of life.

Data for the project are gathered through annual in-person surveys administered by state agencies to a sample of at least 400 older adults and individuals with physical disabilities accessing publicly-funded services in skilled nursing facilities, Medicaid waivers, Medicaid state plans, and/or state-funded programs, as well as older adults served by Older Americans Act programs. The survey instrument includes a background survey, which gathers data about the consumer from agency records, and an in-person survey, which includes subjective satisfaction-related questions that can only be answered by the consumer, and objective questions that can be answered by the consumer or, if needed, their proxy. Project team interprets each state's data and produces reports that can support state efforts to strengthen LTSS policy, inform quality improvement activities, and compare their performance with national norms.

The data collection cycle for the project runs June 1 to May 31 each year.  States interested in learning more are encouraged to contact NASUAD’s NCI-AD Director, April Young.

Project Launch & 2017-18 Survey Year 

NCI-AD officially launched on June 1, 2015, with 13 participating states. Six states agreed to an expedited data collection cycle, which resulted in the release of the Mid-Year report. Since then, NCI-AD participation has grown to 18 states, as shown in the map below. 


The National Core Indicators-Aging and Disabilities (NCI-AD) project grew out of state aging and disabilities agencies’ desire for quantifiable data on the performance of their publicly funded programs for older adult and individuals with physical disabilities. Such data have been available for states’ intellectual/developmental disabilities (I/DD) service systems through the National Core Indicators (NCI) project for the past 18 years.  NCI-AD is designed to assess the performance of the entirety of a state’s publicly funded programs for older adults and people with physical disabilities by collecting and maintaining valid and reliable data on service participants’ quality of life and outcomes.

Since 2012, the National Association of States United for Aging and Disabilities (NASUAD) has been working in collaboration with Human Services Research Institute (HSRI), as well as the National Association of State Directors of Developmental Disabilities Services (NASDDDS) to develop the NCI-AD Consumer Survey.

NASUAD’s Board of Directors voted to begin work on the NCI-AD project in late 2012.  In June 2013, NASUAD and HSRI, with help from the NCI-AD steering committee (comprised of NASUAD board members) and NASDDDS, began amending the Adult Consumer Survey portion of the NCI tool to better align with the priorities of aging and disability service users and systems.  By the end of 2013, the initial survey draft had been revised seven times, based on feedback gathered from the steering committee, stakeholder groups, national-level partners, subject-matter experts, focus groups comprised of older adults and individuals with physical disabilities being served by their state systems, and a pre-pilot test with service participants in Maine.  

In early 2014, Georgia, Minnesota, and Ohio piloted the NCI-AD Consumer Survey.  By the end of August 2014, all three pilot states finished collecting their data.  Project team compiled data from the three pilot states in the NCI-AD Final Pilot Results report.

NASUAD, HSRI, and the NCI-AD Steering Committee worked with stakeholders to revise the survey based on the pilot experience.  In January 2015, the project team conducted a small sample pilot of the revised survey with participants in Georgia.  The survey was revised again based on this pilot and finalized in March 2015.

Development of the NCI-AD tool was supported by NASUAD members and the Administration for Community Living (ACL). 

For more information, contact April Young, NCI-AD Project Director.